title: Does bladder augmentation stabilize serum creatinine in urethral valve disease? A series of 19 cases.
abstract: OBJECTIVE
  This study evaluates the results of bladder augmentation (BA) in 19 boys with posterior urethral valves, especially as regards its efficacy in stabilizing serum creatinine.
  
  
  METHODS
  In the period 1995-2005, 188 patients with urethral valves were surgically managed. Nineteen of these had undergone BA as a part of their surgical management after initial endoscopic valve ablation in 15 and diversion in four boys. The mean serum creatinine at the time of BA was 2.11 mg/dl.
  
  
  RESULTS
  BA stabilized the serum creatinine in 14 but failed to do so in five boys. A serum creatinine level of more than 2mg/dl at the time of BA was associated with a significantly worse rate of success. BA as part of an undiversion procedure in three boys was unsuccessful.
  
  
  CONCLUSIONS
  In an economic milieu where renal transplantation is not available for the majority of deserving children, careful selection is required before BA is considered as a surgical solution for the valve bladder. BA, when otherwise indicated, has been beneficial in children with pre-augmentation creatinine up to 2 mg/dl.
authors.affiliation: Department of Paediatric Surgery, Christian Medical College and Hospital, Vellore, 632004 Tamilnadu, India.
authors.forename: William
authors.initials: W
authors.lastname: Bhatti
authors.forename: Sudipta
authors.initials: S
authors.lastname: Sen
authors.forename: Jacob
authors.initials: J
authors.lastname: Chacko
authors.forename: Gordon
authors.initials: G
authors.lastname: Thomas
authors.forename: Sampath
authors.initials: S
authors.lastname: Karl
authors.forename: John
authors.initials: J
authors.lastname: Mathai
authors.forename: Jacob
authors.initials: J
authors.lastname: George